SENIOR Q&A: When mom goes in for surgery

Tuesday

May 9, 2017 at 6:48 PMMay 17, 2017 at 2:54 PM

By Debbie Gitner and Linda Sullivan / Daily Correspondents

Q: My mother is going into the hospital for minor surgery. What do I need to know to help her and be her advocate? It is expected that she will spend a few nights in the hospital before she can return home. Mom is 85 years old, lives alone and is in fairly good health.

A: The day you bring your mother to the hospital for surgery will be a very long day. It is important to communicate to the anesthesiologist and others in the hospital important information about your mother. Make sure everyone is informed, for example, if she has difficulty hearing, if she has allergies or high blood pressure. Many hospitals have a liaison who can communicate and give you status updates in the pre-surgical waiting area, during surgery and in recovery. If you are worried about how your mother is doing, contact the liaison as often as you need reassurance. That is their role. After surgery, once she has moved to her hospital room, talk with the nurses about your mother living alone and her good health. The nurses will only see an elderly person sleeping and healing, not the independent person you know her to be. You need to continue to explain to everyone your mother’s lifestyle. If your mother would benefit from services in the home then ask for a home visit from a nurse and possibly a physical therapist for strengthening exercises. Insurance should cover for a nurse and therapist. Many hospitals have hospitalists who manage patients' care while they are in the hospital, rather than the primary care physician. In many hospitals there is little continuity from staff; meaning every day your mother could have a new nurse assigned and a new hospitalist. It is important to share information on your mother with every staff member, even if it’s on a daily basis, because a lack of communication can occur when there is a new staff on duty.

Q: I am living in Massachusetts am looking for a Dementia Special Care Unit (DSCU) for my mother, but I am having trouble finding one. Many facilities care for seniors with dementia; however they are not certified. Why is this?

A: In 2014, the Massachusetts Legislature, with the support from the Alzheimer’s Association passed new legislation stating that any facility that wants to call itself a Dementia Special Care Unit must provide a certain level of staffing, a certain number of hours offered in activities per day, (dedicated therapeutic recreational director and activity director), noise reduction with the purchase of special ceiling tiles, special lighting (to reduce shadows and make evening light look like daytime light), certain educational workshops for the entire staff, etc. It is expensive for facilities to make these upgrades, both structurally and by increasing staffing. The facilities with and without this designation are able to provide care for seniors with dementia. The difference can be a better staff-to-patient ratio, noise reduction, lighting to reduce glare to help with sundowning, educational in-services to the staff, etc. It is important to have staff that care, that are gentle, that listen, and want to help. A smiling, caring face goes a long way with someone who has dementia, whether it is a dedicated dementia unit or a facility that provides care to someone with dementia.

Q: My father is having difficulty with his vision. He has stopped driving and has commented to me that his vision is not as sharp as it once was. He has been seen by the ophthalmologist who states he has cataracts (not ripe yet) and macular degeneration. Do you know of any services that can give my father techniques to use for dressing, safety, and overall managing in his home? He was an avid reader and that is also becoming more challenging.

A: Yes there is at least one company in Massachusetts that offers an occupational therapist specially trained in vision loss. This company is able to bill most insurances and offer an OT in the home for a few visits for exactly your concerns with your father. The OT may bring in some adaptive devices and make recommendations on best techniques, home safety, and resources to other agencies if necessary. For example the OT will watch how your father manages in the home rather than make generalizations and observe how things are done for cooking, organizing, reading, taking medications, among other tasks. There are often four to five visits to work on goals and to continue to observe the new techniques, suggestions and recommendations. It can take time to feel comfortable with changes and the OT wants to make multiple visits to check-in and be available to answer more questions and help your father manage with his vision deficits.

Debbie Gitner, LCSW, C-SWCM, is vice president of the New England Chapter of Geriatric Care Managers. Linda Sullivan, R.N., C.M.C., is a registered nurse and certified care manager. Together they are owners of ElderCare Resource Services in Marlborough, helping families navigate resources for seniors. Contact them at 508-879-7008; toll free at 866-280-2308 or visit eldercareresourceservices.com.